| Leigh Peregoy, Lcsw, Inc | |
|
3018 Old Minden Rd 1117a Bossier City LA 71112-2476 | |
| (318) 746-5775 | |
| (318) 703-2854 |
| Full Name | Leigh Peregoy, Lcsw, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 3018 Old Minden Rd, Bossier City, Louisiana |
| Authorized Official Name and Position | Leigh Perry Peregoy (PROVIDER/OWNER) |
| Authorized Official Contact | 3187465775 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leigh Peregoy, Lcsw, Inc 3018 Old Minden Rd 1117a Bossier City LA 71112-2476 Ph: (318) 746-5775 | Leigh Peregoy, Lcsw, Inc 3018 Old Minden Rd 1117a Bossier City LA 71112-2476 Ph: (318) 746-5775 |
| NPI Number | 1730355587 |
|---|---|
| Provider Enumeration Date | 05/01/2008 |
| Last Update Date | 01/22/2013 |
| Medicare PECOS PAC ID | 9133197890 |
|---|---|
| Medicare Enrollment ID | O20040921000057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730355587 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 4456 (Louisiana) | Primary |
| Provider Name | Leigh P Peregoy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225002157 PECOS PAC ID: 3072587948 Enrollment ID: I20040825000954 |
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